Provider Demographics
NPI:1427751817
Name:MONDAY, KRISTEN E (BSE, MS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:MONDAY
Suffix:
Gender:F
Credentials:BSE, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7498 N JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-2879
Mailing Address - Country:US
Mailing Address - Phone:262-844-5155
Mailing Address - Fax:
Practice Address - Street 1:N7498 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-2879
Practice Address - Country:US
Practice Address - Phone:262-844-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI349084174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator